Another Day in the Life of the National Children's Study

Another Day in the Life of the National Children's Study

Article excerpt

Five years ago, the editor of Exceptional Parent Magazine requested that I provide an account of a day in the life of the National Children's Study, an ambitious study by the federal government, the aim of which is to find out how our environment affects child health and development. Now, five years later, I'm excited to provide follow-up--as we've come so far during this time.

To provide background for readers who may not have read the first article, some of the following is adapted from the July 2004 article. The National Children's Study, conceived in 1998 by the President's Task Force on Environmental Health Risks and Safety Risks to Children, was authorized by Congress in the Children's Health Act of 2000. The Study plans to follow 100,000 children from many locations across the United States, from before birth, through pregnancy, to age 21. We plan to measure numerous environmental influences (exposures) and numerous health conditions (outcomes), to discover which exposures influence health and developmental outcomes. The Study's ultimate goal is to enable healthier, safer, happier lives for children and their families.

The National Children's Study defines environment very broadly, to include the biological, chemical, physical and psychosocial-cultural environments. As an example of the biological environment, there are concerns that during pregnancy, a mother's diet or certain other exposures in the unborn baby's environment may predispose the child to developmental or physical disabilities which may become evident during childhood or even later in life. The Study plans to look as well at the influence of the physical environment such as differences in neighborhoods, housing, and climate. We also plan to study psychosocial-cultural influences such as family and community structure and behaviors, economic status and media exposure. And last but not least, we plan to study the chemical environment: whether exposure to certain chemicals either before birth, or during early life, causes problems with child health and development. In addition to looking at direct effects of the environment, we plan to assess the way in which the environment affects how our genes express themselves. It may be that two people inherit similar genes which predispose them to various problems, but just one of those persons is exposed to "triggers" in the environment which enable those genes to express themselves and actually cause those health problems to appear. The National Children's Study is designed to find out just what those "triggers" are, and how we can avoid or influence them for a better outcome. We hope to discover not just the harmful factors which cause ill health, but also the protective or helpful factors which enable some individuals to be more resistant or resilient than others. The data should provide answers to assist healthcare providers in improving healthcare delivery, and also help policy makers take appropriate action to avoid negative environmental impacts on child health and development.

That brings us to ANOTHER Day in the Life of the National Children's Study.

Planning and implementation of the National Children's Study has seen great progress during the past 5 years. In January 2009 we started recruiting participants for the pilot phase of the Study, testing the protocol, the plan that determines how to collect data, in the seven Vanguard locations--Orange County, CA; Duplin County, NC; Queens County, NY; Montgomery County, PA; Salt Lake County, UT; Waukesha County, WI; Lincoln, Pipestone, and Yellow Medicine Counties, MN; and Brookings County, SD. This is called the Vanguard pilot phase. Given the expected "bumps in the road," the challenges of starting new procedures in several very diverse locations, enrollment and initial data collection are proceeding well, a tribute to the strong partnerships forming the infrastructure of this great Study. Results of the pilot study will be used to frame proposals for the Main Study. …